A Comparative Study of Recovery and Postoperative Cognitive Dysfunction After General Anaesthesia with Sevoflurane and Desflurane in Elderly Patients

Abstract Background: Elderly patients are at higher risk of postoperative cognitive dysfunction (POCD), which may delay recovery. Inhalational agents, such as Sevoflurane and Desflurane, differ in their pharmacokinetic properties and may influence early cognitive outcomes. Aim: To compare the effects of Desflurane and Sevoflurane on early recovery and short-term postoperative cognitive function in elderly patients undergoing elective surgery under general anaesthesia. Methods: A prospective randomised study was conducted on 80 patients aged 50–90 years at a tertiary care hospital. Patients received either Desflurane or Sevoflurane as the primary inhalational agent. Emergence parameters (time to spontaneous respiration, eye opening, response to verbal commands, and PACU duration) were recorded. Cognitive function was assessed one hour postoperatively using the MMSE. Independent t-tests and regression analysis were applied. Results: Desflurane resulted in faster emergence, including earlier return of breathing, eye opening, verbal response, and shorter PACU stay (p < 0.001). MMSE scores were higher in the Desflurane group (22.05 vs 17.2), indicating better immediate cognitive recovery. Regression analysis showed that anaesthetic agent, age, and response time were significant predictors of postoperative cognitive function. Conclusion: Desflurane offered faster recovery and better immediate cognitive outcomes than Sevoflurane in elderly patients. It may be preferred when rapid awakening and early cognitive clarity are desired. Further large-scale studies are warranted to confirm these findings and assess long-term effects.